Tatara, Mark J.

Tatara, Mark J. is an individual health care provider with primary practice located at 6840 Main St Ste 200 , Downers Grove IL 60516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tatara, Mark J. can be contacted via phone (630) 869-5382.

Contact Information

Primary practice address
6840 Main St Ste 200 Downers Grove IL 60516
Phone: (630) 869-5382
Fax: (630) 869-5383
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-077438 Illinois

Profile Details

NPI number 1043256324
LBN Legal business name Tatara, Mark J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Dec 23rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043256324 NPPES
Ohio MEDICAID 0795794
Ohio MEDICAID 100355690

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